| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $872.71 | $1,410.00 | $12,615.00 | |
Cigna
| Facility | $606.10 | $606.10 | $606.10 | |
Medcost
| Facility | $872.71 | $1,110.95 | $1,726.74 | |
United
| Facility | $4,015.00 | $15,545.00 | $22,780.00 | |
Wellcare
| Facility | $55.00 | $7,036.40 | $7,036.40 |